Poor children are up to three times more likely to die before age 6

Childhood poverty has negative effects on children’s development, with increased risks of infant mortality, chronic malnutrition, low schooling and teenage pregnancy, and, in the future, a decline in intellectual development.

This is what a study by UFPel (Federal University of Pelotas) shows, published in a series of articles in The Lancet, which analyzed the association between poverty and health and human capital outcomes based on data from 95 countries.

The series will be launched in a webinar this Thursday (28) in London, with the participation of WHO Director-General Tedros Adhanom Ghebreyesus. Among the researchers is the Brazilian epidemiologist Cesar Victora, research leader at UFPel.

The launch comes at a time when there is global concern about the impact of the Covid-19 pandemic on children. Specialists argue that it is urgent to develop public policies against poverty.

In the UFPel study, the authors analyzed data from the six largest birth cohorts in developing countries (Brazil, with two of them, Guatemala, Philippines, South Africa and India). In all, 15,000 children were monitored over a period between 22 and 40 years.

According to Victora, the most striking differences were found in the intelligence quotients (IQ) within two of the Pelotas birth cohorts, initiated in 1982 and 1993. Adults exposed to extreme poverty as children had about 20 points lower on their IQ scores. than children in the richest quintile.

These disparities were also observed in children under five, indicating that factors linked to poverty, such as malnutrition and childhood diseases, have a decisive impact on inequalities in health and intellectual development of these people.

“The concern is that this perpetuates social inequalities throughout life. It is very difficult to get around this, unless we are already in early childhood”, says Victora.

The first thousand days of life, which include pregnancy and the first two years, are critical to determining health and human capital throughout life.

The study evaluated data from national surveys from 95 countries across ten income categories (or deciles), each including 10% of children.

The results show that children in the poorest decile are two to three times more likely to die by the age of five, have short stature and delay in cognitive development for their age, and not complete elementary school — and, among girls , of having children before age 20, when compared to their peers in the richest decile.

The analyzes also indicate that the greater the socioeconomic inequalities in a country, the worse the health, nutrition and cognitive development outcomes of the poorest children.

“The effects persist until adulthood. This is very serious, as it compromises both survival and quality of life and the productive capacity of future generations of children, adolescents and adults”, says Victora.

For the epidemiologist, it is essential that public policy managers recognize the importance of the risks associated with poverty and work towards the creation of multisectoral programs that guarantee social, nutritional and assistance support to children, adolescents and young people, from the beginning of pregnancy.

According to Victora, at the global level, poverty has been falling in the last decade, but the Covid-19 pandemic has worsened the situation.

“Governments, international agencies, major funders need to renew efforts to reach these children from poor families and offset, at least in part, the harmful effects of this Covid pandemic on the most vulnerable.”

The long-term impact of the pandemic on children and families is not yet fully understood. But the evidence suggests that, possibly, interruptions in children’s access to preventive health and education services will result in excess mortality and morbidity in these populations, undermining the gains made in recent years.

In a comment linked to the publication in The Lancet, Tedros Ghebreyesus of WHO and Catherine Russell of UNICEF say: “It is time for solidarity to trump politics, for the sake of our children and future generations. result in an estimated 21 million children and adolescents aged 5 to 24 years and 43 million children under five years of age dying before 2030”.

According to Richard Horton, Editor-in-Chief of The Lancet, “The most extraordinary success story in recent global health history has been the rapid decline in deaths of children under five, yet despite the lives saved, millions of children still die of preventable causes”.

“Those who survive remain unable to reach their full potential. [Precisamos] of political commitment. We need the leaders of multilateral agencies, governments and civil society to address the challenges that this series [de artigos] presents and the opportunities it describes”, he concludes.